Individual
GARY KENNETH DEWEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
633 BROOKDALE DR STE 100, STATESVILLE, NC 28677-3471
(704) 873-7250
(704) 838-1544
Mailing address
PO BOX 1845, STATESVILLE, NC 28687-1845
(704) 873-4277
(704) 978-3549
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
32606
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8928437
—
NC
Enumeration date
03/22/2006
Last updated
05/30/2019
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